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October 20, 2022

Medicaid redetermination update

Our members will soon need to take steps to find out if they can continue their coverage through Medicaid or the Children’s Health Insurance Program (CHIP). This is because states will resume Medicaid and CHIP eligibility reviews upon announcement of the end of the COVID-19 national public health emergency (NPHE).

This means some people with Medicaid or CHIP could be disenrolled from those programs, but they may be eligible to buy a health plan through the Health Insurance Marketplace and get help paying for it.

What can health care professionals do to help prepare their patients?

You can help by reminding patients who have Medicaid to:

  • Update their contact information with the state, ensuring their mailing address, phone number, email or other contact information is correct
  • Check their mail and email for information from the state about coverage and reinstated renewal requirements
  • Complete their renewal application promptly and return it to their state to help avoid a gap in coverage

Things to note

  • Each state is handling redeterminations differently. Specific questions can be directed to your state Medicaid agency.
  • We’re also offering support and information directly to our affected members to help prepare them for Medicaid redetermination 
    • For more information call the number on the member’s ID card
  • If a patient or their family member no longer qualifies for Medicaid or CHIP, they may be able to buy a health plan through the Health Insurance Marketplace
    • HealthCare.gov has information on Marketplace plans
    • Marketplace plans are affordable and comprehensive 
    • Four out of 5 enrollees can find plans that cost less than $10 a month 
    • Most plans cover things like prescription drugs, doctor visits, urgent care, hospital visits and more

Resources

For more details on redeterminations, go to Medicaid.gov.

PCA-1-22-03096-C&S-News_10032022
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